Provider Demographics
NPI:1619205838
Name:KARAMBELKAR, VIBHAKAR V (MSC PT)
Entity Type:Individual
Prefix:MR
First Name:VIBHAKAR
Middle Name:V
Last Name:KARAMBELKAR
Suffix:
Gender:M
Credentials:MSC PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 AMHERST LN
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3304
Mailing Address - Country:US
Mailing Address - Phone:516-603-7033
Mailing Address - Fax:
Practice Address - Street 1:18 AMHERST LN
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3304
Practice Address - Country:US
Practice Address - Phone:516-603-7033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-29
Last Update Date:2009-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012493-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02652573Medicaid